Radiology (bone healing and pathology) - MECHAM Flashcards
What are the 5 histologic stages of bone healing?
- Hematoma formation (immediate)
- Granuloma (0-14 days)
- Callus formation (2-3 weeks)
- Lamellar bone formation (3 weeks - months)
- Remodeling of bone to normal contour
Which of the following is categorized under the Reactive/ Inflammatory phase of bone healing?
(select all that apply)
A. Hematoma formation
B. Granuloma formation
C. Callus formation
D. Lamellar bone formation
E. Remodeling of bone to normal contour
A. Hematoma formation
B. Granuloma formation
Which of the following is categorized under the Reparative phase of bone healing?
(select all that apply)
A. Hematoma formation
B. Granuloma formation
C. Callus formation
D. Lamellar bone formation
E. Remodeling of bone to normal contour
C. Callus formation
D. Lamellar bone formation
Which of the following is categorized under the Remodeling phase of bone healing?
(select all that apply)
A. Hematoma formation
B. Granuloma formation
C. Callus formation
D. Lamellar bone formation
E. Remodeling of bone to normal contour
E. Remodeling of bone to normal contour
Discuss Osteoarthritis (Degenerative Joint Disease):
- Degeneration and disordered repair of ______.
- Is this an inflammatory disorder?
- Degeneration and disordered repair of articular cartilage result in structural failure of synovial joints
- Considered intrinsic cartilage disorder and NOT inflammatory
Occasionally, osteophytes will fracture from the joint and remain as loose bodies within the synovial cavity. These osteophytes are known as _________.
Joint mice
Which of the following is an inflammatory disease?
A. Osteoarthritis
B. Rheumatoid arthritis
B. Rheumatoid arthritis
Rheumatoid Arthritis:
- Autoimmune synovial membrane inflammation in several joints
- TMJ affected in 50% of patients
- Synovial granulation tissue (pannus)
- Can lead to fibrous or osseous ankylosis
Which of the following is characterized by uric acid crystal deposition in joints?
A. Gout
B. Pseudogout
A. Gout
Gout = Uric acid
Pseudogout = Calcium pyrophosphate
Which of the following is characterized by calcium pyrophosphate crystal deposition in joints?
A. Gout
B. Pseudogout
B. Pseudogout
Gout = Uric acid
Pseudogout = Calcium pyrophosphate
What is the difference between osteopenia and osteoporosis?
Osteopenia: less than peak bone mass, considered variation of normal
Osteoporosis: way under peak bone mass; increased risk of fracture
Discuss Rickets and Osteomalacia:
- Both are manifestations of _______ or its abnormal metabolism.
- Which one is seen in children?
Rickets and Osteomalacia are both manifestations of vitamin D deficiency or its abnormal metabolism.
Rickets = children (growth plates)
Osteomalacia = adults
Which of the following conditions contain the highest amount of Alkaline Phosphatase (ALP)?
A. Rickets/Osteomalacia
B. Paget’s disease
C. Hyperthyroidism
D. Multiple myeloma
B. Paget’s disease
Discuss Vitamin D function:
- Vitamin D promotes ______ and _____ absorption in the intestines.
- What hormone does it inhibit?
- Vitamin D promotes calcium and phosphate absorption in the intestines.
-
Vitamin D inhibits PTH production in the parathyroid glands
note: PTH induces bone resorption by reabsorption of calcium in the kidneys
Which of the following causes bone resorption?
A. Vitamin D
B. PTH
B. PTH
Parathyroid Hormone:
- directly increases bone resorption to increase serum calcium
- Increases reabsorption of calcium in the kidneys and expels phosphates
note: if PTH causes bone resorption then what does hyperparathyroidism cause?
* more bone reabsorption
______ is caused by a vitamin C deficiency and can lead to ______.
Scurvy is caused by a vitamin C deficiency and can lead to osteoporosis.
What are the 6 symptoms associated with Hypercalcemia?
hint: they all rhyme
- Stones (kidney stones)
- Bones (osteoporosis)
- Groans (abdominal pain)
- Moans (malaise, lethargy)
- Thrones (polyuria, polydipsia)
- Psychiatric overtones (confusion, memory loss)
______ is a condition characterized by grossly thinned cortex, increased fibrous tissue with foci of hemorrhage and cysts, widespread and multiple lesions. This condition is a result of hyperparathyroidism.
Osteitis Fibrosa Cystica
Discuss Osteopetrosis:
- also known as _____ disease
- Failure of ______ acid activity
- Bones are dense, _______, but ____ and ______ easily.
Osteopetrosis
- also known as marble bone disease
- Failure of osteoclastic acid activity
- Bones are dense, stonelike, but brittle and fracture easily
Which of the following is characterized as “brittle bone disease” due to a defective formation of Type I collagen?
A. Osteoporosis
B. Osteogenesis imperfecta
C. Osteomalacia
D. Osteopetrosis
B. Osteogenesis imperfecta
Which of the following is characterized by a “cotton wool” appearance and enlarged cranium? “My hat doesn’t fit”
A. Osteomyelitis
B. Osteogenesis imperfecta
C. Osteomalacia
D. Osteopetrosis
E. Paget disease
E. Paget disease
Which of the following is characterized by a sequestrum? This disease is typically caused by an S. Aureus infection.
A. Osteomyelitis
B. Osteogenesis imperfecta
C. Osteomalacia
D. Osteonecrosis
E. Paget disease
A. Osteomyelitis
Which of the following is caused by taking bisphosphonates?
A. Osteomyelitis
B. Osteogenesis imperfecta
C. Osteomalacia
D. Osteonecrosis
E. Paget disease
D. Osteonecrosis
Paget’s disease = “cotton wool” appearance
Osteogenesis imperfecta = “brittle bone disease”
Osteomyelitis = sequestrum (bone marrow)
Osteonecrosis = bisphosphonates
Which of the following has the highest levels of alkaline phosphatase (ALP)?
A. Osteomyelitis
B. Osteogenesis imperfecta
C. Osteomalacia
D. Osteonecrosis
E. Paget disease
E. Paget disease
Paget = ALP
______ is characterized by grossly thinned cortex, increased fibrous tissue with foci of hemorrhage and cyst.
Osteitis Fibrosa Cystica
Osteitis Fibrosa Cystica can be caused by ______.
Hyperparathyroidism
What enzyme is extremely high in Paget’s disease?
Alkaline Phosphatase (ALP)
- ALP is important in bone mineralization (turnover)
Discuss Osteopetrosis:
- What are the two names of the disease that cause this?
- Failure of _______ acid activity
- Shows _______ appearance of bone.
- Why is the appearance of bone misleading?
Osteopetrosis
- Albers-Schonber disease or marble bone disease
- Failure of osteoclastic acid activity
- Bones are dense, stone-like, but brittle and fracture easily